Geoff Watkinson believes that it is time to treat teens’ mental health needs the way we treat their physical needs.
It’s time to mandate psychiatric evaluations for high school students. The country is sick, has been sick, and is getting sicker. Let’s stop oversimplifying a complex mental health problem—a problem all of us need to acknowledge exists, and a problem all of us are responsible for fixing. Let’s identify those who are sick at a young age and give them the care they need to get better.
Let’s stop pushing those who need help further and further to the periphery. Let’s start acknowledging, as the National Institute of Mental Health does, that one in every one hundred people suffers from schizophrenia. That more than half of all cases of bi-polar disorder reveal themselves before the age of 25. That 3.3 percent of 13 to 18 year olds have experienced a seriously debilitating depressive disorder. That in 2009 suicide was the third leading cause of death for people aged 15 to 24.
By the time I graduated high school almost ten years ago, I had struggled with substance abuse and depression. I wasn’t alone. I watched many, many friends struggle with depression. I watched fellow students have a bi-polar disorder revealed to them through seemingly unexplained erratic behavior.
Let’s start acknowledging that physical health is nothing without mental health. Let’s start acknowledging that if you’re sick, you need to see a doctor to get better—whether it’s a physical malady or a psychiatric one.
According to the American Academy of Child and Adolescent Psychiatry, a comprehensive psychiatric evaluation runs several hours, sometimes with more than one office visit—with both the adolescent and the parent(s) present. The psychiatrist gathers information about the adolescent’s current symptoms and problems (if there are any), family medical histories, and the adolescent’s relationships. Parents are interviewed. The adolescent is interviewed. Blood tests are conducted, if they’re deemed necessary. The psychiatrist develops a formulation, combining biological, psychological and social characteristics, and the needs of the adolescent. The psychiatrist answers questions from both the adolescent and the parent(s). If a treatable problem is identified, the psychiatrist provides recommendations.
States require students to receive a whole spectrum of vaccinations over the course of their educations. A physical is mandatory for every high school athlete to ensure he or she is not endangering him or herself, or others, while playing sports. A psychiatric evaluation should be required for every high school student between their sophomore and junior years to ensure he or she is not endangering him or herself, or fellow classmates and faculty. By the time the student is around this age—sixteen—he or she has developed behavioral tendencies that can be identified by a psychiatrist.
Let’s consider cost. Although most hospitals don’t list procedure or evaluation costs (a problem in and of itself, but one for another debate), independent psychological firms put the price around $2000 for a comprehensive psychiatric evaluation.
But with the expansion of mental health coverage under the Affordable Car Act, Section 1302 (b), mental health coverage is now considered an “essential health benefit.” Mental health benefits are now required. The out of pocket cost for the evaluation will depend on what state you live in and the policy you have. But certainly, municipalities, states, and the federal government could work together to lower these out of pocket costs. Dare I suggest that Congress pass a piece of legislation to handle these costs? After all, we’re talking about a one-time evaluation. And maybe it doesn’t need to be comprehensive. If essential elements of the evaluation are isolated, the cost could be cut substantially.
According to the National Center for Education Statistics, 4.1 million students began grade 9 in 2013. At $2000 per student, that’s $8.2 billion dollars for every one of those students to receive a comprehensive evaluation. That seems like a lot of money, but we send quite a bit more than that in aid to the Middle East every year.
Is a comprehensive evaluation going to stop school shootings? Maybe not. Will it stop teen suicide? Not completely. Will it identify at-risk teenagers before committing a violent or erratic act? There’s a good chance. Will it help grant access to treatment to those who need it? Absolutely. What’s the cost of doing nothing?
Photo: Mild Mannered Photographer/Flickr